What is hypnosis?
This question, what is hypnosis, is easier to ask than to answer. An entire discipline exists in science to study the complex phenomenon of hypnosis.
Most people have an idea that hypnosis involves some kind of focused attention and an increase in suggestibility.
What few people know is that our narrowed focusing of attention is neurobiologically rooted, it is an ability of the human brain. There are many experiences which involve hypnotic responding with this focused attention. For example, playing video games; watching TV; praying; reading; running all can involve a narrow focus of attention, such that we ignore other things going on around us.
Being suggestible also has neurobiological roots. Our brains contain mirror neurons, cells that assist us in our social interactions, so that infants learn to read the faces of their caregivers and people imitate one another’s behaviors, words and emotions.
Hypnotic responding is a neurobiologically rooted, genetically inherited ability of the human brain. It is an intentional, motivated mode of information processing that allows most humans to alter, to varying degrees, their experience of body, self, actions, and world. (Dell, 2017)
Dell, P. (2017) Is High hypnotizability a necessary diathesis for pathological dissociation? Journal of Trauma & Dissociation, 18:1, 58-87.
The presence of a hypnotist who gives suggestions, called heterohypnosis, seems to merely provide a context in which to facilitate the person’s activation of this innate ability to alter experience. (H. Spiegel, 2007)
You have probably heard people say, “no one can hypnotize me”. Such statements express a person’s dislike of the notion that someone else might be able to affect our minds against our will. But, such statements ignore the fact that we all experience hypnotic responding. In fact, we can actually repeat suggestions to ourselves that become a form of self-hypnosis.
Many definitions of hypnosis describe the heterohypnosis context. For example, from the American Psychological Association:
Hypnosis is a therapeutic technique in which clinicians make suggestions to individuals who have undergone a procedure designed to relax them and focus their minds.
Although hypnosis has been controversial, most clinicians now agree it can be a powerful, effective therapeutic technique for a wide range of conditions, including pain, anxiety and mood disorders. Hypnosis can also help people change their habits, such as quitting smoking.
APA Division 30 – 2014 Revised definition of hypnosis. (Elkins, G; Barabasz, A; Council, J & Spiegel, D. (2015) Advancing Research and Practice: The Revised APA division 30 Definition of Hypnosis. IJCEH, 63:1, 1-9.
Hypnosis: “A state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion.”
Hypnotic induction: “A procedure designed to induce hypnosis.”
Hypnotizability: “An individual’s ability to experience suggested alterations in physiology, sensations, emotions, thoughts, or behavior during hypnosis.”
While the use of the hypnosis skill set in a clinical setting is practiced in a safe manner, and with the best interest of the client or patient in mind, there are concerns about the misuse of hypnotic inductions in entertainment. The following article outlines some of these concerns.
Giuseppe De Benedittis, MD, PhD
Anything that has the power to heal, also has the power to harm (J.Barber, 1998)
Hypnosis for entertainment has long been associated with a higher frequency of unwanted sequelae. This is arguably the more widely practiced form of hypnosis and one about which the majority of clinicians are unanimous in their concerns. Following a series of incidents (e.g., Israel, UK), it has been outlawed in many places.
MacHovec (1988), who provided a comprehensive review of adverse effects, has estimated that stage hypnosis has produced double the risks of clinical and experimental applications.
Lay practitioners lacking in the appropriate level of psychological and clinical training are, therefore, more likely to encounter and cause adverse reactions. Since they lack the skills based on psychodynamic understanding of the processes involved, they are less likely to be able to respond to them therapeutically and ensure the patient’s recovery.
Currently, lack of credentials aside, the context of stage hypnosis does not allow adequate safeguards to be put in place. Stage hypnosis poses risks that are unacceptable and outweigh its potential benefits (De Benedittis, 2009). In our entertainment saturated culture, with its craving for “reality” entertainment, the pleasure of the majority cannot justify the risk of inflicting tragedy on a few (Gruzelier, 2000).
A Professional Hypnotherapist is one who has been trained and degreed by a regionally accredited university or college in the fields of medicine or mental health. In addition, these professionals have been trained in hypnosis and hypnotherapy techniques, which they use with their mental health and medical training, as an additional treatment technique, after a careful psychosocial assessment and evaluation.
A Lay Hypnotist is one who has learned how to help someone enter the trance state referred to as hypnosis. They usually have no accredited training in medicine or mental health. Since a lay hypnotist has no diagnostic skills, they are not able to reliably or legally diagnose any medical and/or psychological problem an individual may have. Further, because the lay hypnotist lacks the needed training in diagnostics, they may not know when a client should be referred to a medical or mental health specialist.
If you are in doubt about the credentials of a therapist, it is important to determine their professional qualifications, license to practice.
Barber, J: When Hypnosis causes trouble. IJCEH, 46: 157-70, 1998.
De Benedittis, G: The dark side of hypnosis. Presented at the XVIII International Congress of Hypnosis, Rome, 2009.
Gruzelier, J: Unwanted effects of Hypnosis: a review of the evidence and its implications. Contemporary Hypnosis, 17:163-193, 2000.
Mac Hovec, F: Hypnosis complications, risk factors and prevention. Am. J. Clin. Hypn., 31:40-9, 1988.
Hypnosis as a scientific discipline
Hypnosis has been both the object of intense research as well as a tool of researchers for many decades. It has been applied to a range of domains, as seen in the diagram below.
A great deal of data exists from research that meets the most stringent guidelines, exploring the mechanisms of hypnosis and the benefits of its application in medicine, psychology and healthcare.
Hypnosis as an effective treatment.
There are two areas in medicine where hypnosis is recognized as an effective treatment: The management of pain and the treatment of irritable bowel symptoms. The following article discussed hypnosis in the management of pain.
Managing pain with hypnosis
Mark P. Jensen, Ph.D. Professor and Vice Chair for Research,
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
Research has demonstrated that hypnosis is an effective treatment for both acute and chronic pain. In fact, given the efficacy and positive “side effect” profile of hypnosis treatment (i.e., its “side effects” are overwhelmingly positive, see discussion later in this article), investigators and clinicians are now starting to view hypnosis as the most appropriate first line pain treatment.
Pain is an important part of daily life and necessary for survival. Pain warns us of the potential of physical damage and therefore protects from that damage. Because of the importance of pain, our brains and bodies are hardwired to pay very close attention to pain. The emotional impact of pain (anxiety, suffering) makes it even more likely that we will pay attention to and make efforts to stop the pain. In most instances, the system works. Pain motivates us to step away from the danger, to rest until we are healed, and avoid situations that could result in damage or even death. Pain is (mostly) our friend.
However, and despite the importance of pain for protecting our health, our readiness to feel pain can cause problems when pain becomes chronic or is no longer useful to us as a warning signal. For example, the acute pain of needed medical procedures (minor surgeries, dental work, shots) is not particularly useful and may in fact motivate us to avoid needed health care. There are also a large number of conditions associated with chronic pain where pain is no longer useful. Chronic back pain can cause people to want to avoid back exercises that are needed for the back pain to resolve, leading to increases in back pain over time. Chronic headache and cause people to take medications which produce short-term decreases in pain but which themselves produce “rebound” headaches (caused by the medications). This can lead to a spiral of increasing headache frequency and intensity over time. Because pain is so closely linked to negative emotions, ongoing chronic pain can cause chronic suffering. This can lead to a decrease in a person’s overall quality of life.
There are a number of medical treatments which can help reduce or eliminate acute pain, and can therefore make medical procedures and dental work easier to manage. However, adding hypnosis to these treatments can reduce anxiety and make medical procedures much easier to tolerate. However, medical treatments have significant problems as treatments for chronic pain. For example, powerful analgesics can (but do not always) reduce pain in the short run, but they rarely eliminate pain. In addition, research is now showing that the use of these medications can actually increase our sensitivity and increase pain in the long run for some people. People can build a tolerance to these medications so they are less effective over time; but their side effects (e.g., constipation, decreases in a person’s ability to think clearly) can become intolerable for many people.
One answer to the problem of pain management is hypnosis. In the last two decades, a great deal of research has studied self-hypnosis training as a method for pain control. The results of this research is clear — self-hypnosis is effective as a treatment for both acute and chronic pain (Jensen, 2009, 2016; Montgomery et al., 2000, 2017). Because hypnosis and hypnotic suggestions for comfort and self-control are known to influence activity in the areas of the brain which produce our pain experience, people who learn self-hypnosis can learn to use this to experience lessen pain. As a result, they are able to do more and hurt less.
Once people learn how to use hypnosis, they often report that just a minute or two of self-hypnosis results in hours of significant pain relief (Jensen et al., 2009a, 2009b). Over time, many people report that their background or usual pain intensity has dropped significantly as well. Interestingly, hypnosis also has a large number of side effects – which are overwhelmingly positive. In our clinical trials of self-hypnosis training, patients reported to us that they were not only feeling less pain, they felt calmer, more in control, and relaxed (Jensen et al., 2006). When one part of your life improves, other parts of your life improve—it’s all connected.
It should not surprise us that when people start taking charge and control of their lives and doing things to feel better, their lives improve. This is what hypnosis treatment is all about: teaching people self-management and self-control.
Jensen, M.P. (2009). Hypnosis for chronic pain management: A new hope. Pain, 146, 235-237.
Jensen, M.P. (2016). Pain management – Chronic pain. In: G.R. Elkins (Ed.), Handbook of medical and psychological hypnosis: Foundations, applications, and professional issues. New York: Springer (pp. 341-360).
Jensen, M.P., Barber, J., Romano, J.M., Hanley, M.A., Raichle, K.A., Molton, I.R., Engel, J.M., Osborne, T.L., Stoelb, B.L., Cardenas, D.D., & Patterson, D.R. (2009a). Effects of self-hypnosis training and EMG biofeedback relaxation training on chronic pain in persons with spinal cord injury. International Journal of Clinical and Experimental Hypnosis, 57, 239-268.
Jensen, M.P., Barber, J., Romano, J.M., Molton, I.R., Raichle, K.A., Osborne, T.L., Engel, J.M., Stoelb, B.L., Kraft, G.H., & Patterson, D.R. (2009b). A comparison of self-hypnosis versus progressive muscle relaxation in patients with multiple sclerosis and chronic pain. International Journal of Clinical and Experimental Hypnosis, 57, 198-221.
Jensen, M.P., McArthur K.D., Barber, J., Hanley, M.A., Engel, J.M., Romano, J.M., Cardenas, D.D., Kraft, G.H., Hoffman, A.J., & Patterson, D.R. (2006). Satisfaction with, and the beneficial side effects of, hypnotic analgesia. International Journal of Clinical and Experimental Hypnosis, 54, 432-447.
Montgomery, G.H., Sucala, M., Baum, T., & Schnur J.B. (2017). Hypnosis for symptom control in cancer patients at the end-of-life: A systematic review. International Journal of Clinical and Experimental Hypnosis, 65, 296-307.
Montgomery, G.H., DuHamel, K.N., & Redd, W.H. (2000). A meta-analysis of hypnotically induced analgesia: how effective is hypnosis? International Journal of Clinical and Experimental Hypnosis, 48, 138-153.